APPLICANT'S ABSTRACT: This proposal seeks two-year funding to evaluate the extent to which managed care (MC), in comparison to traditional Fee-for-Service (FFS) models, affects access and cost of treating Medicaid (MA) eligible adults who have a primary diagnosis of alcohol dependence or abuse. Pennsylvania's health care reform effort for MA recipients creates an opportunity for the policy research community to evaluate a public sector venture into providing behavioral MC services to a large number of individuals with alcohol problems. Philadelphia is the experimental site where the MC intervention began in 1997 and Allegheny County serves as the control or comparison site for the traditional FFS program. The proposed study is a secondary analysis of existing MA data and related data sources conducted by researchers from the School of Social Work and School of Medicine at the University of Pennsylvania, in collaboration with staff of the Philadelphia DOH, the Philadelphia OMH, CODAAP, the Allegheny OMH, and Drug and Alcohol Programs. Questions, hypotheses and analyses are organized around issues of Service Utilization and Cost of Care. Questions related to Utilization (i.e. access, intensity, continuity, substitution) and Cost involve specific hypotheses Generated from the literature and from preliminary studies by the investigator.